Individual
DR. BETHANY E. WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1401 E 87TH ST, CHICAGO, IL 60619-6522
(773) 721-8787
(773) 721-5674
Mailing address
1401 E 87TH ST, CHICAGO, IL 60619-6522
(773) 721-8787
(773) 721-5674
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010246
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
579270056
MEDICARE
IL
05
—
97418002
—
IL
Enumeration date
06/25/2009
Last updated
05/24/2010
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